Rationale and Objectives
To determine if background parenchymal enhancement (BPE) on screening breast magnetic
resonance imaging (MRI) in high-risk women correlates with future cancer.
Materials and Methods
All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013,
were identified. Sixty-one patients who subsequently developed breast cancer were
matched 1:2 by age and high-risk indication with patients who did not develop breast
cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE.
The median reader BPE for each case was calculated and compared between the cancer
and control cohorts.
Results
Cancer cohort patients were high-risk because of a history of radiation therapy (10%,
6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA
mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies
were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18
of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in
the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop
breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval:
1.3–4.8, P = .005). There was fair interreader agreement (κ = 0.39).
Conclusions
High-risk women with greater than minimal BPE at screening MRI have increased risk
of future breast cancer.
Key Words
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Article info
Publication history
Published online: March 27, 2018
Accepted:
March 9,
2018
Received in revised form:
February 24,
2018
Received:
January 19,
2018
Identification
Copyright
© 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
